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Assumptions

Fatigue
Distractions
HIPAA

COMMUNICATION

SUBSECTIONS
• Importance of
Communication
• Communication Definition,
Standards, and Challenges
• Communication Challenges
• Information Exchange
Strategies and Tools (e.g.,
SBAR, Check-Back, Call-
Out, and Handoff)

TIME: 45 minutes
Communication
INSTRUCTOR OUTLINE: COMMUNICATION

Slide

Instructor Note: In this module, you will present information


about communication. It is important to convey the importance of MODULE
communication and how effective information exchange strategies TIME:
can improve patient safety. 45 minutes
The Communication module includes the content provided in the
outline below. More content is available than can be covered in MATERIALS:
the time provided; therefore, optional content and activities are
noted. It is strongly recommended that instruction not focus solely • Flipchart or
on lecture, but also include exercises, videos, and other activities. Whiteboard
As such, instructors should use the information below to plan how (Optional)
the module will be taught within the time available. • Markers
(Optional)
Content Page # Approx. Time
• SBAR Video
1. Introduction 5-6 3 mins (Nurse to
Physician;
2. Importance of 7 2 mins SBAR_INPTMED
Communication _2.mpg)
• Call-Out Video
3. Communication Failures 8-9 3 mins* (Call-
Out_LandD_2.
mpg)
4. Communication: 10 - 15 10 mins
Definition, Standards, (Challenges • Check-Back
Challenges Examples*) Video (Resident
5. Information Exchange 16 - 28 30 mins to Pharmacist;
Strategies Check-
Back_INPTSURG
6. Tools and Strategies 29 2 mins _4.mpg)
Summary
• Handoff Video
7. Applying TeamSTEPPS 30 5 mins (Nurse to Nurse;
Exercise Handoff_INPTSU
*Although all instructional content and activities are recommended to RG_2.mpg)
ensure that participants achieve the learning objectives, these • I PASS the
activities may be considered “optional” if time is constrained. BATON Video
(I_PASS_the_BA
TON_ER.mpg)
• TeamSTEPPS

Implementation



Worksheet

Continued…

TeamSTEPPS 2.0 | Communication B-3-3


INSTRUCTOR OUTLINE: COMMUNICATION
Communication
(Continued)

Slide
Additional Resources: Below are sources of additional
information and videos you may want to use to customize this
module to your participants.
• TeamSTEPPS DVD: The TeamSTEPPS DVD includes
Specialty Scenarios and additional videos that can be used
to customize your instruction.
• TeamSTEPPS Long-Term Care Version: Includes videos
specific to the use of the communication tools and strategies
in long-term care.
• http://www.ahrq.gov/professionals/education /curriculum -
tools/teamstepps/ltc/

• TeamSTEPPS Primary Care Version: Includes videos
specific to the use of the communication tools and strategies in
the primary care setting.
• http://www.ahrq.gov/professionals/education/curriculum -
tools/teamstepps/primarycare/


• TeamSTEPPS Rapid Response Systems Module (RRS):
Includes videos specific to the use of the communication
tools and strategies by Rapid Response Teams.
• http://www.ahrq.gov/professionals/education/curriculum -
tools/teamstepps/rrs/


• DoD Patient Safety Program SBAR Toolkit:
• http://www.health.mil/dodpatientsafety/ProductsandServices/T
oolkits/SBAR.aspx
• Comprehensive Unit-Based Safety Program (CUSP)
“Implement Teamwork and Communication” Module:
Includes information on some of the communication tools
and strategies taught in TeamSTEPPS.
• http://www.ahrq.gov/professionals/education /curriculum -
tools/cusptoolkit/modules /implement/index.html

B-3-4 TeamSTEPPS 2.0 | Communication


Communication
OBJECTIVES

SAY:
Following this module, you will be able to:
• Describe how communication affects team processes and

outcomes;

• Define effective communication;


• Identify communication challenges; and Slide

• Identify TeamSTEPPS tools and strategies that can improve a

team’s communication.

TeamSTEPPS 2.0 | Communication B-3-5


Communication
TEAMSTEPPS TEAMWORK SKILLS

SAY:
So far, we have covered the following in the TeamSTEPPS
framework:
• Team Structure, which facilitates teamwork by identifying
the individuals among which information must be
Slide communicated, a leader must be clearly designated, and
mutual support must occur.
In this module, we will cover Communication. Communication is the
lifeline of a well-functioning team and serves as a coordinating
mechanism for teamwork. Effective communication skills are vital for
patient safety and interplay directly with the other components of the
TeamSTEPPS framework. Further, communication is the mode by
which most of the TeamSTEPPS tools and strategies are executed.
Therefore, this module serves as the basis for the leading teams,
situation monitoring, and mutual support modules that will follow.
This module will discuss the standards of effective communication
and will present information exchange strategies and specific tools
to enhance communication among team members.

B-3-6 TeamSTEPPS 2.0 | Communication


Communication
IMPORTANCE OF COMMUNICATION

SAY:
The continued importance of effective communication in care
teams cannot be understated. According to sentinel event data
compiled by the Joint Commission between 1995 and 2005,
ineffective communication was identified as the root cause of 66
percent of reported errors. More recent Joint Commission data
from 2010 to 2013 show that ineffective communication has Slide
remained among the top three root causes of sentinel events. As
these data illustrate, failure to communicate effectively as a team
significantly increases the risk of error.

Additional information about sentinel events and root causes can


be found on the Joint Commission website:
Joint Commission

TeamSTEPPS 2.0 | Communication


Communication
(OPTIONAL) COMMUNICATION FAILURES

Slide
Instructor Note: Create a slide showing your organizational
data related to the top causal factors for inadequate information
sharing using local, state, regional, or other benchmark data as
appropriate. Discuss findings with the group regarding root cause
analyses from events that occur in your organization or are noted
on your slide.
Examples of contributing factors can be found at:
http://Joint Commission
ASK:
• Can you describe an example in which a communication
breakdown was the major contributing factor of an error in
care?
Instructor Note: The following examples can be read aloud
for discussion, using the questions listed below each example.
Example 1:
• A patient in the Emergency Department needs a chest X-ray to
rule out a pneumothorax (collapsed lung). The physician
requests that the nurse call for a chest X-ray and assumes she
understands his intent of a portable stat. Instead, the patient is
transported to X-ray for a standard AP and Lateral chest X-ray.
ASK:
• What might the physician have said to cause confusion?
• How could the physician more effectively communicate to the
nurse what is needed?
Example 2:
• In obtaining consent for treatment, an explanation written in
sufficient detail in lay terms and at the patient’s level of
understanding is necessary. One potential outcome of a
precompressive lumbar laminectomy is loss of bowel and
bladder control. A consent form that states the known risk as
“loss of function of body organs” does not convey the full extent
of risk associated with the procedure. A patient who fully
understands the risks may choose to forgo the procedure.
ASK:
• How could the consent form be misleading to patients?
• What information should be included and communicated to the
patient so they are fully informed of potential outcomes?
B-3-8 TeamSTEPPS 2.0 | Communication
(OPTIONAL) COMMUNICATION FAILURES
Communication
(Continued)
Slide
SAY:
Lack of communication among department staff can lead to failure
to:
• Share information with the team;
• Request information from others;
• Direct information to specific team members; and

• Include patients and their families in communication involving


their care.
Examples of missed communication opportunities include:
• Unavailable or underutilized status board;
• Inconsistencies in the utilization of automated systems;
• Poor documentation—not timed, nonspecific, illegible, and
incomplete; and

• Failure to seek input from the patient.





In this module, we will discuss approaches to promote effective

communication.

TeamSTEPPS 2.0 | Communication B-3-9


Communication
COMMUNICATION IS…
SAY:
Communication is defined as the transfer or exchange of
information from a sender to a receiver. More specifically,
communication is a process whereby information is clearly and
accurately conveyed to another person using a method that is
known and recognized by all involved. It includes the ability to
Slide ask questions, seek clarification, and acknowledge the message
was received and understood. One critical result of effective
communication is a shared understanding, between the sender
and receiver(s) of the information conveyed.
Two considerations in communication are whom you are
communicating with and how you are communicating information.
• Whom you are communicating with, or the audience, will
influence how information is conveyed. For example, an
information exchange with a lab technician may differ from
an exchange with a physician.
• In terms of how you communicate, there are two modes
of communication: verbal and nonverbal.
We will cover standards of effective communication shortly.
These relate primarily to verbal communication.
Nonverbal communication can take several forms. Written
communication is common in health care. This form of nonverbal
communication should adhere to many of the same standards we
will discuss shortly. In addition, one should be mindful of
standards associated with written communication, such as the
Joint Commission’s “Do Not Use” list of abbreviations.

More information about the “Do Not Use” List of Abbreviations can
be found on the Joint Commission website:
http://www.jointcommission.org/facts_about_the_official/

Continued…

B-3-10 TeamSTEPPS 2.0 | Communication


Communication
COMMUNICATION IS… (Continued)

SAY:
Another form of nonverbal communication is body language. The

way you make eye contact and the way you hold your body during

a conversation are signals that can be picked up by the person




with whom you are communicating. Body language plays a

significant role in communication. In a face-to-face communication,





words account for 7 percent of the meaning, tone of voice



accounts for 38 percent of the meaning, and body language


accounts for the remaining 55 percent. Although powerful, this

mode of communication does not provide an acceptable mode to




verify or validate (acknowledge) information.


A third form of nonverbal communication is visual cues. For


example, the use of color coding for assignments, charts, scrubs,

orders, and so on can help team members identify the information

they need quickly.





To avoid making assumptions that can lead to error, you should

verify in writing or orally any nonverbal communication, such as




body language or visual cues, to ensure patient safety. The


simple rule is, “When in doubt, check it out, offer information, or



ask a question.”

ASK:
• Can you provide examples from your work setting when



nonverbal communication produced a breakdown in


teamwork?



• Did you know the actual intent of the person?

Instructor Note: If responses to the questions above do


not provide sufficient examples, the one below may be read aloud
to participants.
Example:
• The nonverbal cues an ED doctor gives when looking at an

ECG would quickly tell the nurse the severity of the situation

and might lead to proactive action. Likewise, the nonverbal




cues from the nurse’s face might communicate the urgency of


the situation and need for interruption to a doctor who is with



a patient’s family members.

TeamSTEPPS 2.0 | Communication B-3-11


STANDARDS OF EFFECTIVE
Communication
COMMUNICATION

SAY:
When sharing information with the team, which can include other
providers, patients, or family members, communication must meet
four standards to be effective.
Effective communication is:
Slide

Complete

Communicate all relevant information while avoiding unnecessary
details that may lead to confusion

Leave enough time for questions, and answer questions


completely


Clear

Use information that is plainly understood (lay terminology with



patients and their families)




Use common or standard terminology when communicating with

members of the team





Brief

Be concise

Timely

Be dependable about offering and requesting information

Avoid delays in relaying information that could compromise a

patient’s situation




Note times of observations and interventions in the patient’s

record




Update patients and families frequently

Verify authenticity, which requires checking that the information

received was the intended message of the sender





Validate or acknowledge information
Example:
A well-written discharge prescription is:
• Complete—It includes medication, dosage, and frequency
• Clear—It is clearly written and legible
• Brief—It contains only the necessary information
• Concise—It is written before discharge and filled when
the patient is ready to leave the hospital

B-3-12 TeamSTEPPS 2.0 | Communication


Communication
BRIEF, CLEAR, AND TIMELY

SAY:
Provide information that is brief, yet as complete as possible. Do

not overexplain the situation; be concise.




Be clear—Plainly understood.


Timely—Looks like it may be a little too late for these penguins!


Slide

MATERIALS:

Instructor Note: (Time Permitting) Ask the question below • Flipchart or


before proceeding to the next slide, which will list communication Whiteboard
challenges. You may wish to create a list of answers to the (Optional)
question on a flip chart and then compare those to the challenges • Markers
listed on the next slide. (Optional)

ASK:
• What could affect communication among team members?

TeamSTEPPS 2.0 | Communication B-3-13


Communication
COMMUNICATION CHALLENGES

SAY:
Challenges may include:
• Language barriers—Non-English speaking patients/staff
pose particular challenges*
Slide • Distractions—Emergencies can take your attention away
from the current task at hand
• Physical proximity
• Personalities—Sometimes it is difficult to communicate
with particular individuals
• Workload—During heavy workload times, all of the
necessary details may not be communicated, or they may be
communicated but not verified
• Varying communication styles—Health care workers have
historically been trained with different communication
styles
• Conflict—Disagreements may disrupt the flow of
information between communicating individuals
• Lack of verification of information—Verify and
acknowledge information exchanged
• Shift change—Transitions in care are the most significant
time when communication breakdowns occur

ASK:
• Have you experienced a situation in your unit involving
a breakdown of communication?
• What are some examples?

*A TeamSTEPPS Limited English Proficiency Module is available


on the AHRQ website:
TeamSTEPPS Tools

B-3-14 TeamSTEPPS 2.0 | Communication


(OPTIONAL) COMMUNICATION
Communication
CHALLENGES EXAMPLES
Instructor Note: The following examples can be read aloud Slide
to the class and used to facilitate discussion about communication
challenges.
SAY:
Let’s spend a few minutes reviewing an example or two of
scenarios in which communication challenges are present.
Example 1:
A physical therapist sees a patient with carpal tunnel syndrome.
The physical therapist discusses the case with the physician and
recommends ice treatment to decrease inflammation. The
physician agrees with the recommended treatment.

DISCUSSION:
• How would you communicate the treatment protocol to
the patient?
• How would you ensure that the patient understands
the treatment protocol?

Example 2:
An 89-year-old female presents to the hospital and has a history of
chest pain. Many tests are being run to determine the cause of the
chest pain. The patient and her family decide they no longer want
aggressive measures taken and request that the patient’s code
status be changed to DNR. The night shift documents in the
progress note that the patient requested not to be resuscitated.
The night shift does not flag the patient’s chart, relay the
information during shift change, or notify the attending physician.
The morning shift does not read the night shift’s notes because of
several immediate emergencies.

DISCUSSION:
• Where might miscommunication occur in this situation?
• What are the possible outcomes?

TeamSTEPPS 2.0 | Communication B-3-15


Communication
INFORMATION EXCHANGE STRATEGIES

SAY:
A number of tools and strategies to potentially reduce errors
associated with miscommunication or lack of information are
listed. The following four strategies are simple to integrate into
daily practice and have been shown to improve team
Slide performance:
• Situation−Background−Assessment–Recommendation (SBAR)
• Call-Outs
• Check-Backs
• Handoffs

Of these strategies, handoffs in particular can take many forms. In


this course, we will describe the I PASS the BATON handoff tool
in the most detail; however, it is only one tool among many that
have been created to standardize the handoff process. Examples
of additional handoff resources will also be presented.

B-3-16 TeamSTEPPS 2.0 | Communication


Communication
SBAR PROVIDES…

SAY:
The SBAR technique provides a standardized framework for
members of the health care team to communicate about a patient's
condition. You may also refer to this as the ISBAR, where “I”
stands for “Introductions.”
In phrasing a conversation with another member of the team, Slide
consider the following:
• Situation—What is happening with the patient?
• Background—What is the clinical background?
• Assessment—What do I think the problem is?
• Recommendation—What would I recommend?

ASK:
• Have you used SBAR in your institution? If so, how was it
used? What was the result of its use?
• What were the challenges to implement the use of SBAR and
how were these challenges overcome?

SAY:
Although SBAR is typically used as a communication tool between
clinical staff, it can also be modified for use by the patient to
communicate with the care team. For example, your facility could
provide patients with a version of SBAR to enable them to share
information about their own situation, background, assessment,
and recommendations, or to ask the care team about their care.

Additional information about partnering with patients and families


can be found at the Department of Defense (DoD) website:
http://www.health.mil/dodpatientsafety/Pr oductsandSer vices
/team up.aspx

TeamSTEPPS 2.0 | Communication B-3-17


Communication
SBAR VIDEO EXAMPLE

SAY:
Let’s review how to properly use the SBAR technique. In this
video, the patient’s condition has worsened, resulting in a call to
the physician on call. Watch the video to see the transfer of
information using the SBAR technique.
Slide
DO:
Play the video by clicking the director icon on the slide.
VIDEO TIME:
DISCUSSION:
1:35 minutes
• How did the SBAR technique improve communication
between the nurse and physician?
– The nurse identified herself and the reason she was calling
MATERIALS:
– The physician was quickly made aware of Mrs. Everett’s
• SBAR Video deteriorating situation
(Nurse to
– The nurse provided the background of the DVT diagnosis
Physician
SBAR_INPTMED and all current labs
_2.mpg) –
The recent assessment of the patient has led the nurse to
call the physician with her concerns
– The recommendation was initiated by the nurse for
additional labs and a plan was discussed for future care
 Some find recommendation difficult as they attempt not to
diagnose but give broader indirect suggestions that may
not provide clear or concise patient information

B-3-18 TeamSTEPPS 2.0 | Communication


Communication
EXERCISE: SBAR

SAY:
Take the next few minutes to create an SBAR example based on
your specific role.

Instructor Note: You may want to write the following on a


Slide
flipchart to remind participants of the SBAR acronym:
• Situation:
TIME:
• Background:
10 Minutes
• Assessment:
• Recommendation:
MATERIALS:
DO: • Flipchart or
After a few minutes, ask for a few volunteers to share their
Whiteboard
examples. You may want to write out some of the examples
(Optional)
shared by participants.


• Markers
(Optional)

TeamSTEPPS 2.0 | Communication B-3-19


Communication
CALL-OUT IS…

SAY:
A call-out is a tactic used to communicate critical information
during an emergent event. Critical information called out in these
situations helps the team anticipate and prepare for vital next
steps in patient care. It also benefits a recorder when present
Slide during a code or emergent event. One important aspect of a call-
out is directing the information to a specific individual.

VIDEO TIME: ASK:


00:18 seconds
• In your unit, what information would you want called out?

MATERIALS: DO:

• Call-Out Play the video by clicking the director icon on the slide.
Video (Call-
Out_LandD_ DISCUSSION:
2.mpg)
• How did the call-outs made by the nurse and intern aid the
team during this emergent Labor and Delivery event?
– Team members verbally confirmed critical information about
the presence and duration of decelerations
– The team was anticipating future actions, including a
possible C-section and call to Attending
– Information was directed by name to Dr. Dean for response
and feedback

B-3-20 TeamSTEPPS 2.0 | Communication


Communication
CHECK-BACK IS…

SAY:
A check-back is a closed-loop communication strategy used to

verify and validate information exchanged. This strategy involves

the sender initiating a message, the receiver accepting the

message and confirming what was communicated, and the sender




verifying that the message was received.


Here is an example of the use of a check-back: Slide

• One member of the team calls out, “BP is falling, 80/48 down

from 90/60.” Another team member verifies and validates


VIDEO TIME:
receipt of the information by saying, “Got it; BP is falling and at


00:15 seconds
80/48, down from 90/60.” The original sender of the information

completes the loop by saying, “Correct.”



A check-back is an effective tool for all members of the team,
MATERIALS:
including patients and their family members. For example,

patients and families can use the check-back to verify the receipt
• Check-Back
of care instructions or confirm understanding of symptoms to
Video
monitor.
(Resident to
Pharmacist;
Now let’s watch a short example. Check-
Back_INPTS
DO:
URG_4.mpg)
Play the video by clicking the director icon on the slide.
DISCUSSION:
• Who was the sender? Who was the receiver?
– Pharmacist was the sender
– Resident was the receiver
• How did the sender and receiver “close the loop”?
– The pharmacist says “Correct”
• What communication errors were avoided?
– Pharmacist did not rely on memory to give correct dosing

information

– Resident wrote the exact dosing instructions to avoid

depending on memory and could check back using notes

since the dosing was more complicated by dilution




– Errors caused by misunderstood dosage amounts or drugs


with similar sounding names were avoided


TeamSTEPPS 2.0 | Communication B-3-21


Communication
HANDOFF IS…

SAY:
When a team member is temporarily or permanently relieved of
duty, there is a risk that necessary information about the patient
might not be communicated. The handoff strategy is designed to
enhance information exchange at critical times such as transitions
in care. More important, it maintains continuity of care despite
Slide changing caregivers.
According to the Joint Commission: “The primary objective of a
handoff is to provide accurate information about a
patient's/client's/resident's care, treatment and services, current
condition, and any recent or anticipated changes. The information
communicated during a handoff must be accurate to meet patient
safety goals.”
The Joint Commission National Patient Safety Goals (NPSG 2E)
mandate implementing the use of handoffs within each institution.
In addition, a standardized approach to handoff communications,
including an opportunity to ask and respond to questions, is
required.

For more information about Joint Commission handoff solutions,


visit their website:
Joint Commission

ASK:
• When do you typically use handoffs in your unit?
• What do you think makes an effective handoff?

B-3-22 TeamSTEPPS 2.0 | Communication


Communication
HANDOFF CONSISTS OF…

SAY:
A proper handoff includes the following:
• Transfer of responsibility and accountability—When
handing off, it is your responsibility to know that the person who
must accept responsibility is aware of assuming responsibility.
Similarly, you are accountable until both parties are aware of
the transfer of responsibility. Slide
• Clarity of information—When uncertainty exists, it is your


responsibility to clear up all ambiguity of responsibility before

VIDEO TIME:
the transfer is completed.

1:36 minutes
• Verbal communication of information—You cannot


assume that the person obtaining responsibility will read or

understand written or nonverbal communications.




MATERIALS:
• Acknowledgment by receiver—Until it is acknowledged that


the handoff is understood and accepted, you cannot


• Handoff
relinquish your responsibility.


Video (Nurse
to Nurse;
• Opportunity to review—Handoffs are a good time to

Handoff_INPT
review and have a new pair of eyes evaluate the situation

for both safety and quality.




SURG_2.mpg)

In addition, handoffs include the transfer of knowledge and

information about:


• The degree of certainty and uncertainty regarding a patient,

such as whether a diagnosis has been confirmed;




• The patient’s response to treatment;
• Recent changes in condition and circumstances; and
• The plan of care, including contingencies.
It is important to highlight that both authority and responsibility are

transferred in a handoff. As identified in root cause analyses of

sentinel events and poor outcomes, lack of clarity about who is

responsible for care and decisionmaking has often been a major

contributor to medical error.




Let’s watch an example of a handoff.
DO:
Play the video by clicking the director icon on the slide.

DISCUSSION: Go to next page >


Continued…

TeamSTEPPS 2.0 | Communication B-3-23


Communication
HANDOFF CONSISTS OF… (Continued)

Slide
DISCUSSION:
• What went well in the handoff in this video?
– Continuity of care was maintained
– Pain management was discussed
– Medications were reviewed
– Plan of care was discussed
– High threats unique to Mrs. Peters were announced

Expectations and responsibilities for the handoff were

completed


• Was there anything about the handoff that could have
been improved?

Face-to-face or in-person handoffs allow you to see the
nonverbal communication between you and the receiver for
better confirmation that the message has been properly
received

B-3-24 TeamSTEPPS 2.0 | Communication


Communication
I PASS THE BATON
SAY:
Your facility should determine a standard protocol for delivering

handoffs and make it known to everyone. “I PASS the BATON" is

a TeamSTEPPS tool that provides one option for conducting a

structured handoff.


I Introduction—Introduce yourself and your role/job (include
patient) Slide
P Patient—Name, identifiers, age, sex, location
A Assessment—Presenting chief complaint, vital signs,

VIDEO TIME:
symptoms, and diagnosis

1:13 minutes
S Situation—Current status/circumstances, including code

status, level of uncertainty, recent changes, response to treatment



S Safety Concerns—Critical lab values/reports, socio- MATERIALS:
economic factors, allergies, alerts (falls, isolation, etc.)



• I PASS the
THE BATON Video
(I_PASS_the_
B Background—Comorbidities, previous episodes, current


BATON_ER.
medications, family history


mpg)
A Actions—What actions were taken or are required? Provide

brief rationale



T Timing—Level of urgency and explicit timing and

prioritization of actions


O Ownership—Who is responsible (nurse/doctor/team)?


Include patient/family responsibilities


N Next—What will happen next? Anticipated changes? What is

the plan? Are there contingency plans?




DO:
Play the video by clicking the director icon on the slide.

DISCUSSION: Go to next page >

Continued…

TeamSTEPPS 2.0 | Communication B-3-25


Communication
I PASS THE BATON (Continued)

Slide DISCUSSION:

• How was I PASS the BATON used in this physician-to-


physician example?
– Physician shift change (responsibility)
– Evolving patient condition
– Sharing of information for better decisionmaking between
care leaders

B-3-26 TeamSTEPPS 2.0 | Communication


ADDITIONAL HANDOFF TOOLS AND
Communication
RESOURCES

SAY:
Numerous tools and resources are available to facilitate effective
handoffs. Each facility should adopt the tool that best meets its
needs. In addition to I PASS the BATON, other handoff tools and
resources include:
• ANTICipate: Slide
• Stands for - Administrative Data; New clinical information;
Tasks to be performed; Illness severity; and Contingency
plans for changes.
• http://www.psnet.ahrq.gov/primer.aspx?primerID=9
• I PASS:
• Stands for - Illness severity; Patient Summary; Action list for
the new team; Situation awareness and contingency plans;
and Synthesis and “read back” of the information.
• http://www.ipasshandoffstudy.com /
• SHARQ:
• Stands for - Situation; History; Assessment;
Recommendations/Result; and Questions.
• http://accc-cancer.org/oncology_issues/articles
/MarApr2011/MA11- Sherer.pdf
• HAND-IT:
• Stands for the Handoff Intervention Tool.
• http://www.ncbi.nlm.nih.gov/pm c/articles /PMC354051 1/
• Patient Hand-Off Tool Kit:
• This resource includes 10 examples of handoff tools.
• http://www.aorn. org/PracticeResources/ToolKits/Patien
tHandOffToolKit/
• Safer Sign Out Form:
• This tool was developed to standardize the sign-out process.
• http://safersignout.com /resources/

Continued…
TeamSTEPPS 2.0 | Communication B-3-27
ADDITIONAL HANDOFF TOOLS AND
Communication
RESOURCES (Continued)

Slide
ASK:
• Can you describe an example of the handoff method used
in your facility?
• Is the same handoff method used in every situation, or do
they vary?

B-3-28 TeamSTEPPS 2.0 | Communication


Communication
TOOLS AND STRATEGIES SUMMARY

SAY:
Communication skills interact directly with leadership, situation
monitoring, and mutual support:

• Team leaders require effective communication skills to


convey clear information, provide awareness of roles and
responsibilities, and provide feedback. Slide
• Team members monitor situations by communicating any
changes to keep the team informed and the patient
protected.
• Communication facilitates a culture of mutual support when
team members request or offer assistance and verbally
advocate for the patient.
Communication tools that can enhance teamwork include the
SBAR, call-out, check-back, and handoff. These tools facilitate
effective and efficient communication within and across teams.
Good communication facilitates the development of shared mental
models, adaptability, mutual trust, and patient safety.

TeamSTEPPS 2.0 | Communication B-3-29


Communication
EXERCISE: APPLYING TEAMSTEPPS

Instructor Note: This slide is intended for the Master


Training course only. The previous slide should be the last one
shown to staff participants at your organization.

SAY:
Slide
Now return to your TeamSTEPPS Implementation Worksheet.
Think about the teamwork issue you previously identified. Then,
MATERIALS: review and answer the questions for Module 3.
• TeamSTEPPS Think about:
Implementation
Worksheet • Whether your teamwork issue relates to problems
with communication; and
• Whether any of the tools and strategies covered in this
module could be used to address your issue.

DO:
Ask a few individuals to report on their communication issue and
which TeamSTEPPS tools or strategies they will consider
implementing to address the issue.

B-3-30 TeamSTEPPS 2.0 | Communication